Description:
BACKGROUND:It is well known that the condition and type of sporting ground influences the risk of sports injury. However, the lack of evidence on the relationship between subjective and objective sporting ground condition assessments in sports injury aetiology studies has implications for the development of effective injury prevention strategies. This paper aims to examine concordance between subjectively rated and objective ground hardness and moisture measurements to inform data collection methods for future sports injury aetiology studies. METHODS:Subjective, observational assessments of ground hardness and soil moisture were recorded on 36 occasions during an Australian football season using two four-point scales of 'very soft' to 'very hard' and 'very wet' to 'very dry', respectively. Independent, objectively measured hardness and soil moisture were also undertaken at nine locations on the same grounds. The maximum and minimum ground values and the computed average of ground hardness and soil moisture were analysed. Somer's d statistic was calculated to measure the level of concordance between the subjective and objective measures. RESULTS:A significant, moderate to substantial level of agreement was found between the subjective ratings and the average objective hardness values (d = 0.467, p <0.001), but there was perfect agreement on just less than half of the occasions. The level of concordance between the subjective and objective moisture ratings was low to moderate or trivial for all moisture measures (0.0020.05). CONCLUSIONS:Compared to objective measures, the subjective assessments were more accurate for ground hardness than for soil moisture levels and raters were just as likely to underestimate or overestimate the condition under review. This has implications for future sports injury aetiology studies that include ground condition assessments and particularly the use of subjective measures to underpin the development of future injury prevention strategies.
Description:
BACKGROUND:It is well known that the condition and type of sporting ground influences the risk of sports injury. However, the lack of evidence on the relationship between subjective and objective sporting ground condition assessments in sports injury aetiology studies has implications for the development of effective injury prevention strategies. This paper aims to examine concordance between subjectively rated and objective ground hardness and moisture measurements to inform data collection methods for future sports injury aetiology studies. METHODS:Subjective, observational assessments of ground hardness and soil moisture were recorded on 36 occasions during an Australian football season using two four-point scales of 'very soft' to 'very hard' and 'very wet' to 'very dry', respectively. Independent, objectively measured hardness and soil moisture were also undertaken at nine locations on the same grounds. The maximum and minimum ground values and the computed average of ground hardness and soil moisture were analysed. Somer's d statistic was calculated to measure the level of concordance between the subjective and objective measures. RESULTS:A significant, moderate to substantial level of agreement was found between the subjective ratings and the average objective hardness values (d = 0.467, p <0.001), but there was perfect agreement on just less than half of the occasions. The level of concordance between the subjective and objective moisture ratings was low to moderate or trivial for all moisture measures (0.0020.05). CONCLUSIONS:Compared to objective measures, the subjective assessments were more accurate for ground hardness than for soil moisture levels and raters were just as likely to underestimate or overestimate the condition under review. This has implications for future sports injury aetiology studies that include ground condition assessments and particularly the use of subjective measures to underpin the development of future injury prevention strategies.
Description:
BACKGROUND:Previous research aimed at improving injury surveillance standards has focused mainly on issues of data quality rather than upon the implementation of surveillance systems. There are numerous settings where injury surveillance is not mandatory and having a better understanding of the barriers to conducting injury surveillance would lead to improved implementation strategies. One such setting is community sport, where a lack of available epidemiological data has impaired efforts to reduce injury. This study aimed to i) evaluate use of an injury surveillance system following delivery of an implementation strategy; and ii) investigate factors influencing the implementation of the system in community sports clubs. METHODS:A total of 78 clubs were targeted for implementation of an online injury surveillance system (approximately 4000 athletes) in five community Australian football leagues concurrently enrolled in a pragmatic trial of an injury prevention program called FootyFirst. System implementation was evaluated quantitatively, using the RE-AIM framework, and qualitatively, via semi-structured interviews with targeted-users. RESULTS:Across the 78 clubs, there was 69% reach, 44% adoption, 23% implementation and 9% maintenance. Reach and adoption were highest in those leagues receiving concurrent support for the delivery of FootyFirst. Targeted-users identified several barriers and facilitators to implementation including personal (e.g. belief in the importance of injury surveillance), socio-contextual (e.g. understaffing and athlete underreporting) and systems factors (e.g. the time taken to upload injury data into the online system). CONCLUSIONS:The injury surveillance system was implemented and maintained by a small proportion of clubs. Outcomes were best in those leagues receiving concurrent support for the delivery of FootyFirst, suggesting that engagement with personnel at all levels can enhance uptake of surveillance systems. Interview findings suggest that increased uptake could also be achieved by educating club personnel on the importance of recording injuries, developing clearer injury surveillance guidelines, increasing club staffing and better remunerating those who conduct surveillance, as well as offering flexible surveillance systems in a range of accessible formats. By increasing the usage of surveillance systems, data will better represent the target population and increase our understanding of the injury problem, and how to prevent it, in specific settings.
Description:
BACKGROUND:Previous research aimed at improving injury surveillance standards has focused mainly on issues of data quality rather than upon the implementation of surveillance systems. There are numerous settings where injury surveillance is not mandatory and having a better understanding of the barriers to conducting injury surveillance would lead to improved implementation strategies. One such setting is community sport, where a lack of available epidemiological data has impaired efforts to reduce injury. This study aimed to i) evaluate use of an injury surveillance system following delivery of an implementation strategy; and ii) investigate factors influencing the implementation of the system in community sports clubs. METHODS:A total of 78 clubs were targeted for implementation of an online injury surveillance system (approximately 4000 athletes) in five community Australian football leagues concurrently enrolled in a pragmatic trial of an injury prevention program called FootyFirst. System implementation was evaluated quantitatively, using the RE-AIM framework, and qualitatively, via semi-structured interviews with targeted-users. RESULTS:Across the 78 clubs, there was 69% reach, 44% adoption, 23% implementation and 9% maintenance. Reach and adoption were highest in those leagues receiving concurrent support for the delivery of FootyFirst. Targeted-users identified several barriers and facilitators to implementation including personal (e.g. belief in the importance of injury surveillance), socio-contextual (e.g. understaffing and athlete underreporting) and systems factors (e.g. the time taken to upload injury data into the online system). CONCLUSIONS:The injury surveillance system was implemented and maintained by a small proportion of clubs. Outcomes were best in those leagues receiving concurrent support for the delivery of FootyFirst, suggesting that engagement with personnel at all levels can enhance uptake of surveillance systems. Interview findings suggest that increased uptake could also be achieved by educating club personnel on the importance of recording injuries, developing clearer injury surveillance guidelines, increasing club staffing and better remunerating those who conduct surveillance, as well as offering flexible surveillance systems in a range of accessible formats. By increasing the usage of surveillance systems, data will better represent the target population and increase our understanding of the injury problem, and how to prevent it, in specific settings.
Independent appraiser assessment of the quality, methodological rigour and transparency of the development of the 2008 international consensus statement on concussion in sport
Description:
Aim: In recent years, considerable effort has been devoted to the development and revisions to an international consensus statement on concussion in sport (ICSCS). The aim of this study was to obtain expert views on the methodological rigour and transparency with which the 2008 ICSCS was developed, as a precursor to the development of the 2012 update. Methods: Delegates registered for the 2012 fourth International Conference on Concussion in Sport, selected local concussion researchers not involved in any prior international consensus meetings, and all authors of the 2008 ICSCS published paper were invited to assess the methodological rigour and transparency with which the 2008 ICSCS was developed. The online Appraisal of Guidelines for Research and Evaluation (AGREE) II assessment tool, with six quality domains, was used and domain scores were expressed as a percentage of the maximum possible score for that domain. Results: 18 appraisers completed the online AGREE II assessment. Ten appraisers said they would recommend the 2008 ICSCS for use (without modification) and seven said they would recommend its use with some modification. The 'scope and purpose' and 'clarity of presentation' were rated highest, both scoring 78%. The lowest scoring domain was 'applicability' with a score of 55%. Conclusions: The quality of the ICSCS is important because it is used to guide return-to-play decisions and the management of sport-related concussions. This appraisal of the 2008 ICSCS suggests that a greater focus is needed on the actual implementation of future ICSCS and the relationship between implementation and desired health outcomes.
Description:
Aim: In recent years, considerable effort has been devoted to the development and revisions to an international consensus statement on concussion in sport (ICSCS). The aim of this study was to obtain expert views on the methodological rigour and transparency with which the 2008 ICSCS was developed, as a precursor to the development of the 2012 update. Methods: Delegates registered for the 2012 fourth International Conference on Concussion in Sport, selected local concussion researchers not involved in any prior international consensus meetings, and all authors of the 2008 ICSCS published paper were invited to assess the methodological rigour and transparency with which the 2008 ICSCS was developed. The online Appraisal of Guidelines for Research and Evaluation (AGREE) II assessment tool, with six quality domains, was used and domain scores were expressed as a percentage of the maximum possible score for that domain. Results: 18 appraisers completed the online AGREE II assessment. Ten appraisers said they would recommend the 2008 ICSCS for use (without modification) and seven said they would recommend its use with some modification. The 'scope and purpose' and 'clarity of presentation' were rated highest, both scoring 78%. The lowest scoring domain was 'applicability' with a score of 55%. Conclusions: The quality of the ICSCS is important because it is used to guide return-to-play decisions and the management of sport-related concussions. This appraisal of the 2008 ICSCS suggests that a greater focus is needed on the actual implementation of future ICSCS and the relationship between implementation and desired health outcomes.
Description:
Objectives: Far fewer injury surveillance systems exist within community sport than elite sport. As a result, most epidemiological data on sports injuries have limited relevance to community-level sporting populations. There is potential for data from community club-based injury surveillance systems to provide a better understanding of community sports injuries. This study aimed to describe the incidence and profile of community-level Australian football injuries reported using a club-based injury surveillance system. Design: Prospective, epidemiological study. Methods: Sports trainers from five community-level Australian football leagues recorded injury data during two football seasons using the club-based system. An online surveillance tool developed by Sports Medicine Australia ('Sports Injury Tracker') was used for data collection. The injury incidence, profile and match injury rate were reported. Results: Injury data for 1205 players were recorded in season one and for 823 players in season two. There was significant variability in injury incidence across clubs. However, aggregated data were consistent across football seasons, with an average of 0.7 injuries per player per season and 38-39 match injuries per 1000. h match exposure. A large proportion of injuries occurred during matches, involved the lower limb and resulted from contact. Conclusions: Data from the club-based system provided a profile of injuries consistent with previous studies in community-level Australian football. Moreover, injury incidence was consistent with other studies using similar personnel to record data. However, injury incidence was lower than that reported in studies using player self-report or healthcare professionals and may be an underestimate of true values.
Investigation of older adults’ participation in exercises following completion of a state-wide survey targeting evidence-based falls prevention strategies
Description:
This paper examines whether involvement in an observational study may prompt participants to change their exercise behaviors. Data was collected from 394 older community dwellers in Victoria, Australia using a baseline survey, and 245 of these participated in a follow-up survey one year later. Survey domains were drawn from constructs of relevant health behavior models. Results showed that the proportion of respondents who were currently participating in exercises to prevent falls at follow-up was 12% higher than at baseline (Wilcoxon p value<0.001). Twenty-nine percent reported they had changed their perceptions about falls and their risk of falls, with comments focused on threat appraisal. Forty-four percent reported having taken strategies to reduce their risk of falling, with comments based on implementation of different preventive strategies. Respondents who held favorable views towards exercises for the prevention of falls appear to change their behaviors that might address falls when participating in observational studies.
Description:
This paper examines whether involvement in an observational study may prompt participants to change their exercise behaviors. Data was collected from 394 older community dwellers in Victoria, Australia using a baseline survey, and 245 of these participated in a follow-up survey one year later. Survey domains were drawn from constructs of relevant health behavior models. Results showed that the proportion of respondents who were currently participating in exercises to prevent falls at follow-up was 12% higher than at baseline (Wilcoxon p value<0.001). Twenty-nine percent reported they had changed their perceptions about falls and their risk of falls, with comments focused on threat appraisal. Forty-four percent reported having taken strategies to reduce their risk of falling, with comments based on implementation of different preventive strategies. Respondents who held favorable views towards exercises for the prevention of falls appear to change their behaviors that might address falls when participating in observational studies.
Description:
Aim: The need for accurate diagnosis and appropriate return-to-play decisions following a concussion in sports has prompted the dissemination of guidelines to assist managing this condition. This study aimed to assess whether key messages within these guidelines are reflected in the knowledge of coaches and sports trainers involved in community sport. Methods: An online knowledge survey was widely promoted across Australia in May–August 2012 targeting community Australian Football (AF) and Rugby League (RL) coaches and sports trainers. 260 AF coaches, 161 AF sports trainers, 267 RL coaches and 228 RL sports trainers completed the survey. Knowledge scores were constructed from Likert scales and compared across football codes and respondent groups. Results: General concussion knowledge did not differ across codes but sports trainers had higher levels than did coaches. There were no significant differences in either concussion symptoms or concussion management knowledge across codes or team roles. Over 90% of respondents correctly identified five of the eight key signs or symptoms of concussion. Fewer than 50% recognised the increased risk of another concussion following an initial concussion. Most incorrectly believed or were uncertain that scans typically show damage to the brain after a concussion occurs. Fewer than 25% recognised, and >40% were uncertain that younger players typically take longer to recover from concussion than adults. Conclusions: The key messages from published concussion management guidelines have not reached community sports coaches and sports trainers. This needs to be redressed to maximise the safety of all of those involved in community sport.
Description:
Aim: The need for accurate diagnosis and appropriate return-to-play decisions following a concussion in sports has prompted the dissemination of guidelines to assist managing this condition. This study aimed to assess whether key messages within these guidelines are reflected in the knowledge of coaches and sports trainers involved in community sport. Methods: An online knowledge survey was widely promoted across Australia in May–August 2012 targeting community Australian Football (AF) and Rugby League (RL) coaches and sports trainers. 260 AF coaches, 161 AF sports trainers, 267 RL coaches and 228 RL sports trainers completed the survey. Knowledge scores were constructed from Likert scales and compared across football codes and respondent groups. Results: General concussion knowledge did not differ across codes but sports trainers had higher levels than did coaches. There were no significant differences in either concussion symptoms or concussion management knowledge across codes or team roles. Over 90% of respondents correctly identified five of the eight key signs or symptoms of concussion. Fewer than 50% recognised the increased risk of another concussion following an initial concussion. Most incorrectly believed or were uncertain that scans typically show damage to the brain after a concussion occurs. Fewer than 25% recognised, and >40% were uncertain that younger players typically take longer to recover from concussion than adults. Conclusions: The key messages from published concussion management guidelines have not reached community sports coaches and sports trainers. This needs to be redressed to maximise the safety of all of those involved in community sport.
Description:
The Australian Fitness Industry Risk Management (AFIRM) Project was set up to explore the operation of rules and regulations for the delivery of safe fitness services. This article summarises the results of recent focus group research and a national survey of risk management practices by the AFIRM Project. Our focus group research in four States identified the following most important concerns: (1) the competency of fitness professionals; (2) the effectiveness of pre-exercise screening and the management of de-conditioned clients; (3) poor supervision of fitness service users and incorrect use of equipment; (4) fitness trainers failing to remain within their scope of practice; (5) equipment misuse (as distinct from incorrect use); and (6) poor fitness training environments. This information was then used to develop 45 specific items for a questionnaire that was disseminated throughout the fitness industry. The survey, which is the largest ever conducted in the Australian fitness industry (n = 1,178), identified similar concerns. Our research indicates that efforts to improve risk management in the fitness industry should focus, first and foremost, on the development and monitoring of safety policy, and improvements in the education and training of fitness instructors to ensure that they can incorporate risk management practices.
Description:
Objectives Consistency in routines for reporting injury has been a focus of development efforts in sports epidemiology for a long time. To gain an improved understanding of current reporting practices, we applied the Injury Definitions Concept Framework (IDCF) in a review of injury reporting in a subset of the field. Design Meta-narrative review, An analysis of injury definitions reported in consensus statements for different sports and studies of injury epidemiology in athletics (track and field) published in PubMed between 1980 and 2013 was performed. Separate narratives for each of the three reporting contexts in the IDCF were constructed from the data. Results Six consensus statements and 14 studies reporting on athletics injury epidemiology fulfilled the selection criteria. The narratives on sports performance, clinical examination, and athlete self-report contexts were evenly represented in the eligible studies. The sports performance and athlete self-report narratives covered both professional and community athletes as well as training and competition settings. In the clinical examination narrative, data collection by health service professionals was linked to studies of professional athletes at international championships. Conclusions From an application of the IDCF in a review of injury reporting in sports epidemiology we observed a parallel usage of reporting contexts in this field of research. The co-existence of reporting methodologies does not necessarily reflect a problematic situation, but only provided that firm precautions are taken when comparing studies performed in the different contexts.
Description:
AbstractObjectives Australian Football League (AFL) players have a high risk of injury. Anecdotally, this injury risk is greater in emerging players (i.e. those in their first year), compared with established players (with 3+ years of experience). This study aimed to conduct the first comparison of injury risk and playing experience in these two player groups across a large number of AFL clubs. Design Prospective, cohort. Methods Injuries, game participation and training participation were collected weekly by 8 AFL clubs for 61 emerging and 64 established players. Injury incidence rates (IIR) and Cox proportional hazard models for time to first injury, separately for games and training, were computed. Results The game IIR was significantly higher for emerging than established players: 45.6 (95% CI: 35.7, 57.6) versus 18.3 (95% CI: 13.1, 24.9) per 1000 game-hours. Emerging players also had a higher training IIR than did the established players: 9.6 (95% CI: 7.6, 11.9) versus 8.9 (95% CI: 7.0, 11.1) per 1000 training-hours. Emerging players were significantly less likely to remain injury free in games than established players (HR = 3.46, 95% CI: 1.27, 9.45). A similar outcome was seen in training sessions, although to a lesser degree (HR = 1.41, 95% CI: 1.19, 1.69). Conclusions Despite efforts to modify the playing/training program of emerging players, this group remain at greater risk of injury in games and training sessions, compared with established players. Continued efforts should be made toward understanding reasons for this increased risk to better prevent injury during the early years of a professional football career.
Description:
Background: Injuries are often recurrent, with subsequent injuries influenced by previous occurrences and hence correlation between events needs to be taken into account when analysing such data. Objective: This paper compares five different survival models (Cox proportional hazards (CoxPH) model and the following generalisations to recurrent event data: Andersen-Gill (A-G), frailty, Wei-Lin-Weissfeld total time (WLW-TT) marginal, Prentice-Williams-Peterson gap time (PWP-GT) conditional models) for the analysis of recurrent injury data. Methods: Empirical evaluation and comparison of different models were performed using model selection criteria and goodness-of-fit statistics. Simulation studies assessed the size and power of each model fit. Results: The modelling approach is demonstrated through direct application to Australian National Rugby League recurrent injury data collected over the 2008 playing season. Of the 35 players analysed, 14 (40%) players had more than 1 injury and 47 contact injuries were sustained over 29 matches. The CoxPH model provided the poorest fit to the recurrent sports injury data. The fit was improved with the A-G and frailty models, compared to WLW-TT and PWP-GT models. Conclusions: Despite little difference in model fit between the A-G and frailty models, in the interest of fewer statistical assumptions it is recommended that, where relevant, future studies involving modelling of recurrent sports injury data use the frailty model inpreference to the CoxPH model or its other generalisations. The paper provides a rationale for future statistical modelling approaches for recurrent sports injury.
Description:
Background: Injuries are often recurrent, with subsequent injuries influenced by previous occurrences and hence correlation between events needs to be taken into account when analysing such data. Objective: This paper compares five different survival models (Cox proportional hazards (CoxPH) model and the following generalisations to recurrent event data: Andersen-Gill (A-G), frailty, Wei-Lin-Weissfeld total time (WLW-TT) marginal, Prentice-Williams-Peterson gap time (PWP-GT) conditional models) for the analysis of recurrent injury data. Methods: Empirical evaluation and comparison of different models were performed using model selection criteria and goodness-of-fit statistics. Simulation studies assessed the size and power of each model fit. Results: The modelling approach is demonstrated through direct application to Australian National Rugby League recurrent injury data collected over the 2008 playing season. Of the 35 players analysed, 14 (40%) players had more than 1 injury and 47 contact injuries were sustained over 29 matches. The CoxPH model provided the poorest fit to the recurrent sports injury data. The fit was improved with the A-G and frailty models, compared to WLW-TT and PWP-GT models. Conclusions: Despite little difference in model fit between the A-G and frailty models, in the interest of fewer statistical assumptions it is recommended that, where relevant, future studies involving modelling of recurrent sports injury data use the frailty model inpreference to the CoxPH model or its other generalisations. The paper provides a rationale for future statistical modelling approaches for recurrent sports injury.
Description:
Objective: To estimate the burden of hospitalised fall-related injury in community-dwelling older people in Victoria. Methods: We analysed fall-related, person-identifying hospital discharge data and patient-level hospital treatment costs for community-dwelling older people aged 65+ years from Victoria between 1 July 2005 and 30 June 2008, inclusive. Key outcomes of interest were length of stay (LOS)/episode, cumulative LOS (CLOS)/patient and inpatient costs. Results: The burden of hospitalised fall-related injury in community-dwelling older people aged 65+ years in Victoria was 284,781 hospital bed days in 2005-06, rising to 310,031 hospital bed days in 2007-08. Seventy-one per cent of episodes were multiday. One in 15 acute care episodes was a high LOS outlier and 14% of patients had ≥1 episode classified as high LOS outlier. The median CLOS/patient was nine days (interquartile range 2-27). The annual costs of inpatient care, in June 2009 prices, for fall-related injury in community-dwelling people aged 65+ years in Victoria rose from $213 million in 2005-06 to $237 million in 2007-08. The burden of hospitalised fall-related injury in community-dwelling older women, people aged 85+ years and those with comorbidity was considerable. Conclusions: The burden of hospitalised fall-related injury in community-dwelling older people aged 65+ years in Victoria is significantly more than previously projected. Importantly, this study identifies that women, patients with comorbidity and those aged 85+ years account for a considerable proportion of this burden. Implications: A corresponding increase in falls prevention effort is required to ensure that the burden is properly addressed.
Description:
Background Injury knowledge and beliefs influence uptake of prevention programmes, but the relationship between knowledge, beliefs and adherence remains unclear. Aim To describe injury knowledge and beliefs among youth female soccer coaches and players, and to identify the relationship between these factors, different delivery strategies of the FIFA 11+ programme and adherence. Methods A subcohort analysis from a cluster-randomised controlled trial of 31 female soccer teams (coaches n=29, players (ages 13-18) n=258). Preseason and postseason questionnaires were used to assess knowledge and beliefs. Teams recorded FIFA 11+ adherence during the season. Results At baseline, 62.8% (95% CI 48.4% to 77.3%) of coaches and 75.8% (95% CI 71.5% to 80.1%) of players considered 'inadequate warm-up' a risk factor for injury. There was no effect of delivery method (OR=1.1; 95% CI 0.8 to 1.5) or adherence (OR=1.0; 95% CI 0.9 to 1.1) on this belief. At baseline, 13.8% (95% CI 1.3% to 26.4%) of coaches believed a warm-up could prevent muscle injuries, but none believed it could prevent knee and ankle injuries. For players, 9.7% (95% CI 6.1% to 13.3%), 4.7% (95% CI 2.1% to 7.3%) and 4.7% (95% CI 2.1% to 7.3%) believed a warm-up would prevent muscle, knee and ankle injuries, respectively. Years of playing experience were negatively associated with high adherence for coaches (OR=0.93; 0.88 to 0.99) and players (OR=0.92; 0.85 to 0.98). Conclusions There were gaps in injury knowledge and beliefs, which differed for coaches and players. Beliefs did not significantly affect adherence to the FIFA 11+, suggesting additional motivational factors should be considered.
Description:
Background Team ball sports such as soccer, basketball and volleyball have high participation levels worldwide. Musculoskeletal injuries are common in team ball sports and are associated with significant treatment costs, participation loss and long-term negative side effects. The results of recent randomized controlled trials provide support for the protective effect of injury-prevention exercise programmes (IPEPs) in team ball sports, but also highlight that achieving adequate compliance can be challenging. A key process in enhancing the ultimate impact of team ball sport IPEPs is identifying the specific implementation components that influence the adoption, execution and maintenance of these interventions. Despite this, no systematic review focussing on the specific implementation components of team ball sport IPEPs has been conducted. Objectives Our objective was to assess the reporting of specific implementation components in the published literature on team ball sport IPEPs using the Reach Efficacy Adoption Implementation Maintenance (RE-AIM) framework. Methods Six electronic databases were systematically searched from inception to December 2012 for papers reporting team ball sport IPEP trials. All eligible papers were independently evaluated by two raters before reaching consensus on the reporting of individual RE-AIM items, using the RE-AIM Model Dimension Items Checklist (RE-AIM MDIC). Results A total of 60 papers, reporting 52 unique intervention trials, met eligibility criteria. Before consensus, the level of agreement across all trials between reviewers using the RE-AIM MDIC ranged from 81 to 91 %. The RE-AIM MDIC dimension of 'efficacy' had the highest level of reporting, with the five individual items in this dimension reported in 19-100 % of eligible trials (mean 58 %). The RE-AIM MDIC dimension 'maintenance-setting level' had the lowest level of reporting, with none of the four individual items in this dimension reported. For other dimensions, the mean level of reporting and range across items were 'reach' 34 % (12-60 %); 'adoption-setting level' 1 % (0-2 %); 'adoption-delivery agent level' 7 % (4-10 %); 'implementation' 36 % (13-63 %) and 'maintenance individual level' 1 % (0-4 %). Conclusion Information on the specific implementation components of team ball sport IPEPs in published studies is scarce. In particular, major reporting gaps exist regarding the adoption and maintenance of these programmes. The RE-AIM MDIC can be successfully applied to reviewing literature in this context.
Description:
The protection of an athlete's health and preventing injuries and illnesses in sport are top priorities for the IOC and its Medical Commission. The IOC therefore partners with selected research centres around the world and supports research in the field of sports medicine. This has enabled the IOC to develop an international network of expert scientists and clinicians in sports injury and disease prevention research. The IOC wants to promote injury and disease prevention and the improvement of physical health of the athlete by: (1) establishing long-term research programmes on injury and disease prevention (including studies on basic epidemiology, risk factors, injury mechanisms and intervention), (2) fostering collaborative relationships with individuals, institutions and organisations to improve athletes' health, (3) implementing and collaborating with applied, ongoing and novel research and development within the framework and long-term strategy of the IOC and (4) setting up knowledge translation mechanisms to share scientific research results with the field throughout the Olympic Movement and sports community and converting these results into concrete actions to protect the health of the athletes. In 2009, the IOC also identified four research centres that had an established track record in research, educational and clinical activities to achieve these ambitions: (1) the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Australia; (2) the Sport Injury Prevention Research Centre (SIPRC), Canada; (3) the Clinical Sport and Exercise Medicine Research (CSEM), South Africa and (4) the Oslo Sports Trauma Research Center (OSTRC), Norway. This paper highlights the work carried out by these four IOC Centres of Excellence over the past 6 years and their contribution to the world of sports medicine.
Description:
Injuries in team ball sports (eg, soccer, handball, volleyball and basketball) are common, accounting for 44% of all nonfatal sports injuries in the 27 EU Nations.1 Combined with high participation rates, this gives team ball sports the potential to pose significant health burdens, and highlights the importance of preventing injuries in this context.
Time to add a new priority target for child injury prevention? The case for an excess burden associated with sport and exercise injury : Population-based study
Description:
Objective: To determine the population-level burden of sports injuries compared with that for road traffic injury for children aged <15 years in Victoria, Australia. Design: Retrospective observational study. Setting: Analysis of routinely collected data relating to non-fatal hospital-treated sports injury and road traffic injury cases for children aged <15 years in Victoria, Australia, over 2004-2010, inclusive. Participants: 75 413 non-fatal hospital-treated sports injury and road traffic injury cases in children aged <15 years. Data included: all Victorian public and private hospital hospitalisations, using the International Statistical Classification of Diseases and Health Related Problems, 10th Revision, Australian Modification (ICD-10-AM) activity codes to identify sports-related cases and ICD-10-AM cause and location codes to identify road traffic injuries; and injury presentations to 38 Victorian public hospital emergency departments, using a combination of activity, cause and location codes. Main outcome measures: Trends in injury frequency and rate were analysed by log-linear Poisson regression and the population-level injury burden was assessed in terms of years lived with disability (YLD), hospital bed-days and direct hospital costs. Results: Over the 7-year period, the annual frequency of non-fatal hospital-treated sports injury increased significantly by 29% (from N=7405 to N=9923; p<0.001) but the frequency of non-fatal hospital-treated road traffic injury decreased by 26% (from N=1841 to N=1334; p<0.001). Sports injury accounted for a larger population health burden than did road traffic injury on all measures: 3-fold the number of YLDs (7324.8 vs 2453.9); 1.9-fold the number of bed-days (26 233 vs 13 886) and 2.6-fold the direct hospital costs ($A5.9 millions vs $A2.2 millions). Conclusions: The significant 7-year increase in the frequency of hospital-treated sports injury and the substantially higher injury population-health burden (direct hospital costs, bed-day usage and YLD impacts) for sports injury compared with road traffic injury for children aged <15 years indicates an urgent need to prioritise sports injury prevention in this age group.
Description:
Objective: To determine the population-level burden of sports injuries compared with that for road traffic injury for children aged <15 years in Victoria, Australia. Design: Retrospective observational study. Setting: Analysis of routinely collected data relating to non-fatal hospital-treated sports injury and road traffic injury cases for children aged <15 years in Victoria, Australia, over 2004-2010, inclusive. Participants: 75 413 non-fatal hospital-treated sports injury and road traffic injury cases in children aged <15 years. Data included: all Victorian public and private hospital hospitalisations, using the International Statistical Classification of Diseases and Health Related Problems, 10th Revision, Australian Modification (ICD-10-AM) activity codes to identify sports-related cases and ICD-10-AM cause and location codes to identify road traffic injuries; and injury presentations to 38 Victorian public hospital emergency departments, using a combination of activity, cause and location codes. Main outcome measures: Trends in injury frequency and rate were analysed by log-linear Poisson regression and the population-level injury burden was assessed in terms of years lived with disability (YLD), hospital bed-days and direct hospital costs. Results: Over the 7-year period, the annual frequency of non-fatal hospital-treated sports injury increased significantly by 29% (from N=7405 to N=9923; p<0.001) but the frequency of non-fatal hospital-treated road traffic injury decreased by 26% (from N=1841 to N=1334; p<0.001). Sports injury accounted for a larger population health burden than did road traffic injury on all measures: 3-fold the number of YLDs (7324.8 vs 2453.9); 1.9-fold the number of bed-days (26 233 vs 13 886) and 2.6-fold the direct hospital costs ($A5.9 millions vs $A2.2 millions). Conclusions: The significant 7-year increase in the frequency of hospital-treated sports injury and the substantially higher injury population-health burden (direct hospital costs, bed-day usage and YLD impacts) for sports injury compared with road traffic injury for children aged <15 years indicates an urgent need to prioritise sports injury prevention in this age group.
Description:
AIM: Injuries are common in all professional football codes (including soccer, rugby league and union, American football, Gaelic Football and Australian football). The aim of the present study was to assess the potential effect that rule changes can have on injuries in professional football. METHODS: The Australian Football League (AFL) conducts an annual audit of injuries and makes regular rule changes on a semi-annual basis. An injury was defined as “any physical or medical condition that causes a player to miss a match in the regular season or finals” with ongoing records kept and publicly released over the decade 2004-2013. RESULTS: Over the ten years from 2004-2013, the AFL Commission made 26 rule changes, of which eight were considered to have potential impact on injury rates. The 2005 centre circle rule has significantly reduced rates of posterior cruciate ligament (PCL) injury in ruckmen. The rates of head and neck injuries dropped after initial rule changes, but rates of concussion and other head and neck injuries have increased since 2011, since a rule change that players could not re-enter the game after suffering concussion. Rates of hamstring and groin injuries have significantly fallen since the substitute rule was instituted in 2011, but rates of other lower limb injuries have risen over the same time period. CONCLUSION: Rule changes have, in some instances, had a beneficial effect on the rates of specific injuries over the last decade. However, the overall injury incidence in the AFL has not fallen, possibly because of a concurrent background increase in the speed of player movement across the decade. The AFL is in a fortunate position of being able to easily institute rule changes as it is the peak body of the sport which does not have to consider international competitions. The well established annual injury survey is able to monitor the effects of any rule changes on injury rates in a timely manner.